Guidelines for the Prevention of Intravascular Catheter-related Infections: Recommendations Relevant to Interventional Radiology

Abstract

THE revised version of the Centers for Disease Control Guidelines for the Prevention of Intravascular Catheterrelated Infections was published on August 9, 2002, in the Morbidity and Mortality Weekly Report Reports and Recommendations series (1). It replaces the previous guideline published in 1996. The goal of the new guidelines is to provide evidencebased recommendations for preventing catheter-related infections. The new document was prepared by a working group led by the Society of Critical Care Medicine, in collaboration with the Infectious Disease Society of America, Society for Healthcare Epidemiology of America, Surgical Infection Society, American College of Chest Physicians, American Thoracic Society, American Society of Critical Care Anesthesiologists, Association for Professionals in Infection Control and Epidemiology, Infusion Nurses Society, Oncology Nursing Society, Society of Interventional Radiology, American Academy of Pediatrics, and the Healthcare Infection Control Practices Advisory Committee of the Centers for Disease Control. Major areas of emphasis in the new guidelines include (i) education and training of health-care providers who insert and maintain catheters, (ii) use of maximal sterile barrier precautions during central venous catheter (CVC) insertion, (iii) use of a 2% chlorhexidine preparation for skin antisepsis, (iv) avoidance of routine replacement of CVCs as a strategy to prevent infection, and (v) use of antisepticor antibiotic-impregnated short-term CVCs if the rate of infection is high despite adherence to other strategies (ie, education and training, maximum sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). The full guideline, available without charge at http:// www.cdc.gov/mmwr/PDF/RR/RR5110.pdf, is lengthy and includes numerous other recommendations (1). Portions of the new guideline are of particular interest to interventional radiologists, particularly those dealing with CVCs, peripherally inserted central catheters (PICCs), and hemodialysis catheters. Selected recommendations are presented verbatim here, along with selected supporting data, background information, and references.